Dr Raj Kumar Sharma
The theme for World Diabetes Day 2021-23 is Access to Diabetes Care.
The focus of the campaign in 2023 is on delaying or preventing type 2 diabetes and diabetes-related complications, with the slogan “Know your risk, know your response.” World Diabetes Day (WDD) was created in 1991 by IDF and the World Health Organization in response to growing concerns about the escalating health threat posed by diabetes. World Diabetes Day became an official United Nations Day in 2006 with the passage of United Nation Resolution 61/225. It is marked every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.
WDD is the world’s largest diabetes awareness campaign reaching a global audience of over 1 billion people in more than 160 countries. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public and political spotlight.
The frequency of diabetes is rising around the world, and studies are showing children are at increasing risk of developing the disease. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys and nerves, causing chronic problems and early death.
Type 1 diabetes (sometimes called insulin-dependent, juvenile or childhood-onset diabetes) occurs when the pancreas does not produce enough insulin, a hormone that regulates blood sugar. The cause is not known, but it is thought to be the result of a combination of genetic and environmental factors.
Many countries are documenting higher numbers of newly diagnosed cases of type 1 diabetes, particularly in younger children. Interestingly, some disease patterns among children resemble infectious disease epidemics. Currently, there is no known way to prevent type 1 diabetes.
Type 2 diabetes (sometimes called non-insulin-dependent or adult-onset diabetes) happens when the body cannot effectively use the insulin it produces. Often preventable, it can result from excess body weight and physical inactivity, and sometimes, a genetic predisposition.
Recently, type 2 diabetes has increasingly been reported in children and adolescents, so much so that in some parts of the world type 2 diabetes has become the main type of diabetes in children. The global rise of childhood obesity and physical inactivity is widely believed to play a crucial role. Healthy eating and lifestyle habits are a strong defence against the disease.
In India, there are estimated 77 million people above the age of 18 years are suffering from diabetes (type 2) and nearly 25 million are prediabetics (at a higher risk of developing diabetes in near future). More than 50% of people are unaware of their diabetic status which leads to health complications if not detected and treated early. The worst affected is the fourth smallest states of the country Goa with 26.4% prevalence while the most populous state UP has 4.8 % prevalence of diabetes. Puducherry with 26.3% and Kerala with 25.5% take the second and third spot in the chart. While UP has managed to keep diabetes at bay for now, the study warns of a sharp rise in the metabolic disorder in the state. Madhya Pradesh, Bihar and Arunachal Pradesh also have low prevalence rate of diabetes but the cases are growing fast. In terms of diabetes prevalence, the southern and northern regions of India exhibit the highest rates, with urban areas consistently showing high prevalence. Conversely, the central and northeastern regions have lower prevalence rates. For prediabetes prevalence, the central and northern regions of India have the highest rates, while Punjab, Jharkhand, and certain parts of the northeastern region exhibit lower prevalence. Notably, there is no significant difference in pre diabetes prevalence between urban and rural areas.
Type 2 diabetes accounts for over 90% of all diabetes. There are several steps that can be taken to reduce the risk of developing the condition.
Unhealthy eating habits and sedentary lifestyles associated with urbanisation are common factors contributing to the development of type 2 diabetes. There is overwhelming evidence from studies in the USA, Finland, China, India and Japan that lifestyle changes (achieving a healthy body weight and moderate physical activity) can help prevent the development of type 2 diabetes in people at risk.
Reducing the risk of type 2 diabetes involves a balanced diet and regular physical activity. Maintaining a healthy weight is crucial as overweight and obesity increases the risk. Even a small weight loss can make a big difference. Regular screenings and check-ups, especially for people with one or more of the risk factors, can detect early signs and help individuals make the necessary changes to delay or prevent the onset of type 2 diabetes.
Several risk factors have been associated with type 2 diabetes and include:
* Family history of diabetes
* Unhealthy diet
* Physical inactivity
* Increasing age
* High blood pressure
* Impaired glucose tolerance (IGT)*
* History of gestational diabetes
* Poor nutrition during pregnancy
Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.
Adults with diabetes have a two- to three-fold increased risk of heart attacks and strokes. Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection, and the eventual need for limb amputation. Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Diabetes is among the leading causes of kidney failure.
Some of the preventive tips to control diabetes are:
* Avoid sugar and refined carbohydrate intake
* Practice to eat small portion of meals at one time
* Include fibers and food which are low in glycemic index
* Quit smoking, which promotes insulin resistance
* Make a habit of regular exercise for at least 30 minutes a day
* Keep eyes on your blood cholesterol level
* Have proper management of your blood pressure, which should be 130/80 or lower
* Avoid intake of aerated drinks and other beverages with added sugar, which can raise the risk of type 2 diabetes, make a habit of consuming normal water.
* Get updated with diabetes control preventive tips
* Promote and encourage the diabetes related campaign to spread the awareness to the needy ones
Regular medical checkup especially monitoring HbA1c every 3 months adherence to diet and exercise and medication as prescribed by the Doctor can go long way in controlling of diabetes and its complications. There is no magical cure of diabetes and people should not be carried away by the malicious campaigns highlighted by the different social media platforms. Patients should adhere to the prescriptions given by the doctor and should not change according to the advice of the friends who are also taking other medications for the control of diabetes.
Dr Raj Kumar Sharma